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General NPI Number Information
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NPI Number | 1629332267
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Entity Type | Organization
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Legal Business Name | L. I. P. LIVING IN PURPOSE HEALTH CARE INC.
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Dates
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Enumeration Date | 06/28/2012
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Last Update Date | 07/10/2012
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Provider Practice Location Address
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Address Line | 2900 LUELL ST
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City | HOUSTON
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State | TX
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Zip | 77093-7634
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Country | US
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Telephone | 832-250-6682
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Fax | 281-812-3352
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Provider Business Mailing Address
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Address Line | P. O. BOX 11303
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City | HOUSTON
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State | TX
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Zip | 77293
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Country | US
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Telephone | 832-250-6682
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Fax | 281-812-3352
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. LARRY D. MONTGOMERY
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Credential |
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Telephone | 832-250-6682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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